The broad objective of this research is to evaluate the relative efficacy of pharmacotherapy and psychotherapy, alone and in combination, for the treatment of acutely depressed nonpsychotic, nonbipolar, outpatients diagnosed as having a primary major depressive disorder by RDC criteria. Specifically, this treatment assessment research project will compare the relative efficacy of imipramine, cognitive-behavior therapy, and imipramine in combination with cognitive-behavior therapy against a "traditional" psychotherapy and "psychotherapy-on-demand" control group. The acute phase of treatment will last 3-4- months, followed by a maintenance treatment or evaluation follow-up phase of 8-9 months. Psychotherapy will be given in a group format and outcome ratings will be obtained from therapists, patients, and "significant" others. The study should provide a construct replication of the Rush, et al (1977), study which reported a therapeutic advantage for cognitive-behavior therapy compared with imipramine in the treatment of depressed outpatients diagnosed by Feighner criteria as primary affective disorder, unipolar type.